Advice on getting a dental implant

In My Humble Opinion (IMHO)
#1

My dental history is not so great. It started when I was a pre-teen, getting sealants on my teeth at school. The dentist did not do a good job and I ended up with two teeth(right side, 2nd molar, top and bottom) that needed root canals about 3 years later. During those root canals and numerous fillings, the dentist I had traumatized me and I developed a dental work fear.

In college, my two root canals failed and I went through the worst pain of my life. Unfortunately, I was broke so I didn’t get the work done to fix the root canals at that time and, instead, waited about 7 years for the pain to build up and help me get over my dental fear.

As a result of the failed root canals, bad mouth bacteria and another really bad cavity, I had to have my two back bottom molars on my right side extracted. Now, let me tell you, that was the best thing that has ever happened to my mouth. I hadn’t realized how much pain I was in until it was gone. It was miraculous. And it was also a year and half ago.

Now, my dentist is (really has been) recommending I get an implant to replace those two back molars and restore a lot more chewing surface. I finally have the money together but I’m still real nervous. My dental anxiety doesn’t help but I also worried about how this will work, what I should make sure they do and all that.

So, those of you that have had implants, how can I make this go well? Any advice?

#2

Paging rsat3acr, will Dr. rsat3acr please come to the thread…

(He’s a member who’s a dentist)

#3

I wouldn’t do it for myself. Getting implants is not really painless. 2 lost molars is not the worst thing in the world. Concentrate your efforts into caring for your remaining teeth and not losing anymore. IMO.

#4

If you have no difficulty currently chewing I’d say no. I don’t have my two back molars and I don’t miss them at all, chew everything just fine.

My objection to dental implants is that they don’t always go well. And when they don’t, there is no fix, and the person is left with a real mess and often pain.

I wouldn’t risk it for teeth I don’t even miss.

You waited 7yrs last time. I suggest you put off this decision for a couple of months. Then re evaluate whether you ‘need’ them at all. And maybe reflect on why a dentist would be trying to sell you such an expensive treatment, if you don’t.

Just one opinion.

Good Luck!

#5

I just got finished with an implant and the experience has been fine. I was knocked out for both the extraction and the implant of the post into the bone.
No issues and very little pain post surgery.

The implant, from start to finish, took a LOT longer than I expected, though. In my case, I could have gone with a permanent bridge and I would have had #14 (top molar) back pretty quick, but since my insurance paid half for the implant, I decided to go that way.

Depending on circumstances, I would probably do it again.

#6

If you can afford implants then get them. The process can take months, there will be a few long, uncomfortable, possibly painful sessions in the chair, but then it’s done and you are set for life. Just like when you had those bad teeth extracted and you are going to be glad that you did it. Don’t ask dentists whether or not to do it*, they always have great teeth, take it from someone like me that couldn’t bite or chew food if not for implants who regrets waiting so long before I got them.

*Obviously you take a good dentist’s advice on whether it is feasible. But if it is feasible, and get a second opinion on that, then d it. Go into debt if yhave to. It is worth it.

#7

One clarification, this would be one implant to replace two molars side by side. Right now, I don’t have much chewing surface on my right side and basically don’t chew on that side at all.

I wasn’t expecting this much of a split on this. But my dentist also didn’t tell me too much about what can go wrong with the implants, probably because he didn’t want to make me more anxious than I already am. I think my biggest hang up is that they are literally going to put a screw into my jaw and that sounds horrible. But I’m also only 29 and, with as many problems as I’ve had with my teeth, I don’t want to risk losing more teeth prematurely.

That said, I really do trust his recommendations. He didn’t push me to keep the two teeth that were clearly too far gone. He has worked with me on payment plans and he is really patient with my overactive gag reflex. Seriously, one time he was giving me a filling and I started to gag and I PUSHED his hands out of my mouth while I coughed. He was super cool about it.

#8

Do you still have your wisdom teeth? I had mine until age 42 when the dentist said it was getting too hard for me to clean around them and they’ll develop problems, so they should come out. Since I was in for extraction of the wisdom teeth, at the same time (while I was under sedation) they also did the surgery for the implant post. My dental insurance covered the wisdom teeth surgery and the implant wasn’t much of an additional charge.

Now 18 years later, I’ve never had a problem with the implant; I think it was a good decision.

#9

Don’t assume dental implants are always permanent. I had a complete set of upper implants. My dentist warned me that they can get infected, especially if I’m a smoker. I assured him that I hadn’t smoked since 1979. I don’t know how, but they became infected. By the time the infection was discovered, it had spread, and they all had to be removed. Additional surgery, additional money.

I now have an upper denture.

#10

I asked my dentist if my implants would look natural when I wore a bathing suit. He told me I’d be fine if I didn’t go too large.

#11

Thanks for thinking of me Broomstick. ** Slalexan**, if this dentist has been patient and helpful that is a very good sign. He may have not wanted to bring it up until you were in a bit better shape to handle the situation. Of course he may have just taken a course on implants and wants to get started. I’d ask, he shouldn’t be offended. I’d guess the former.
While many people get by with few teeth, less teeth to chew with means more stress on the remaining teeth. More chewing surface is almost always going to be better.
In a situation like this the are basically three options. Do nothing, probably not the best long term option for the remaining teeth on that side but not a horrible option. Second you could get a removable partial denture. I personally wouldn’t want a removable in my mouth. Tough to get a good fit and don’t really get that much chewing out of them since they are not solid. They are considerably cheaper than implants and take less time to fabricate. Implants can be as strong or stronger than real teeth. Their main drawbacks are the expense and they time to place. Implants are shaped like a screw but aren’t screwed in. A hole is made in the gum and bone and the implant fits in it flush with the gum. The bone integrates into the implant over the course of three or four months. After that a post is placed into the implant and a crown is made for it. Implants take no more maintenance then teeth, good oral hygiene, brushing and flossing. Implants can fail however they are very successful most of the time. Failure is usually the bone failing to integrate or separate after a load is placed on them(sort of like bone loss in gum disease).

Hope this helps.

#12

depends on the cut of the suit also

#13

There was another thread about this just a few weeks ago.

https://boards.straightdope.com/sdmb/showthread.php?t=859761&highlight=dental+implants

#14

I’m following along here because I will lose my third upper molar on Friday and the dentist says stressing the remaining smaller teeth will start destroying them rapidly. I definitely notice the loss of chewing area.

One oral surgeon, 20 years ago, said I have so little bone above my upper teeth that implants would never be possible. Apparently much of the root of each upper molar is just sticking up into the sinus and not anchored in bone. Supposedly that has something to do with why I’m losing them. But another oral surgeon recently said I could get implants with no problem. I’m not sure how to reconcile these opinions, unless perhaps the technology for dealing with thin bone has improved over these 20 years. Any thoughts?

#15

Second OS probably is considering a sinus lift. Pretty hefty surgery where the floor of the sinus is raised giving more bone in the upper jaw to enable enough bone for the implant. The roots of the teeth aren’t actually in the sinus. There is a small layer of bone between the root and the sinus but the sinus extending down the root effectively means there is less bone holding it in and therefore much more sensitive to bone loss due to periodontal(gum)disease.

#16

I have an implant and three root canals. I also have dental phobia. Valium, it turns out, makes me weep uncontrollably. This was awesome to learn while at a specialist dentist I’d never gone to before. For my implant, my doc prescribed a mild benzo, and I had nitrous as well as a numbing agent while the work was being done. That was a really good combo for me.

On the whole, I’m glad I got the implant. Chewing on one side really messed up my jaw and it would only be getting worse without the implant. Also, it’s astonishing how far back in someone’s mouth you can see when they smile or talk, and a lot of people will make a lot of assumptions about someone who is missing a tooth, or teeth.

I understand that the jawbone slowly erodes when it’s not being used and that changes the shape of your whole face.

I grind my teeth. This causes problems. It rocks the implant (and all my teeth) around. This still, years later, can sometimes cause soreness in the bone because the screw is unforgiving. Grinding also wears down the level of natural teeth, but the implant doesn’t grind down. Then it’s too “high” and I need the dentist to grind the crown down to match the height of the other teeth or, again, pain.

My gums are receding. I can now feel the base of the crown and sometimes food gets stuck in there. I worry that I won’t notice an infection until it’s really bad because there’s no nerve, but that would be true of a root canal, too. I don’t know if the nature of the implant means the crown can’t go as deep in the gum, or if I’m just unlucky.

#17

I know it probably varies widely, but can anyone ballpark the cost of an implant?

And what percent the average dental insurance might cover?
mmm

#18

If you can spare a few months, have it done in Thailand. I had a great dentist there for about 20 years, and he did two implants and three bridges. The last implant/bridge combo (that bridge replaced an older one) was in 2016 before I returned to the US. His cost was 100,000 baht, but he reduced it for me to 90,000. That was equal to about US$2600. It took a few months and several trips. The pain was minimal. My new dentist here in Hawaii has praised his work.

This was more of a neighborhood dentist, but he was damned good. Trained in the US. If you go to one of the Western-style hospitals or dental clinics that target Westerners, you’ll pay more than I did.

#19

I have dental implants & would encourage you to get it done. In my case, I was referred to an oral surgeon who (under general anesthesia/no pain) put the implant in the bone. Then later, my dentist put the crown on the implant. I riddled the oral surgeon with questions about everything that could go wrong. They do fail, but long term failure is usually due to bone loss, and given that you are only 29, you would be at low risk for that, according to my oral surgeon (I got mine in my 30s). He said his highest rate of failure is with elderly patients. Of course there are issues of short term failure caused by poor placement, infection, etc, but your doc will prescribe antibiotics & if your docs are competent, you will do great! I say go for it!

#20

Wow $2600 is a bargain. I paid over $10k for 2 implants (I’m in Southern California). Since the OP is getting one implant for 2 teeth, he’ll only need one implant, then a 2 tooth crown so that should be cheaper than 2 individual implants, I would think. What did they quote you OP? And have you seen Little Shop of Horrors? :smiley: